2001 Did you know that Lyme disease can become chronic?



Did you know that Lyme disease can become chronic? Do you check yourself and your children frequently after participating in high-risk activities? Tick bites should always be taken seriously. When diagnosed in the early stages, Lyme disease is usually curable. However, if it progresses to later stages before diagnosis, symptoms can sometimes develop into chronic ailments. Lyme disease (LD) may also become a chronic condition in patients who are treated inappropriately. (Inappropriate treatment may include the wrong type of antibiotic, low dosage prescriptions, not finishing prescribed antibiotics and other patient compliance issues.) Two specific issues that may contribute to chronic LD or recurring symptoms include diagnostic procedures and proper tick removal.

Diagnosing Lyme Disease

Unfortunately, diagnosing LD can be difficult in some patients. The most common first symptom of LD is a rash around the site of the tick bite. A rash may be easily overlooked, especially by patients who are unaware of their exposure to a tick. Patients who are not familiar with LD may not recognize the rash, or they may not think the rash is severe enough to seek medical attention. Another problem with LD is the potential for misdiagnosis. There are tests available to screen the blood for antibodies. (The body produces these antibodies in response to the bacteria that causes the infection.) Unfortunately, a high number of both false positive and false negative results are produced with these testing procedures. For example, when blood tests are conducted within one month of infection, a false negative result is possible because the incubation period for LD is 7 to 14 days. This means that the body does not start to produce enough antibodies to be detected until after this length of time. There are also other factors that contribute to the reliability of the current LD tests. The FDA recommends that healthcare providers use a complete clinical evaluation including medical history, symptoms, high-risk activities and possible exposure to ticks in the diagnostic process of early stage LD. The blood tests may be used for supplemental purposes but should not be the preferred diagnostic tool. This complicated diagnostic process emphasizes the importance of prevention.

Preventing Lyme Disease

Most cases of LD are preventable. For more information on LD prevention, visit Lyme Disease — What’s Your Risk? (link to other article) One important aspect of prevention is properly removing a tick when found on the body.

How To Remove A Tick

Ticks will climb upward until they find a protected place where they can attach to the skin. Some common hiding places may include under the armpits, the hairline, inside the navel or behind the knees. After attaching, infected ticks will not begin transmitting LD for at least 36 to 48 hours. This is why frequent body checks are so important. If one finds a tick before it has been attached for this length of time, the risk of infection is decreased. Proper tick removal may also contribute to the risk of LD. The American Lyme Disease Foundation (ALDF) recommends using "unrasped fine-pointed tweezers" to remove a tick. (These tweezers have tips that will close tightly together.) A tick should be grasped with the tweezers at the head where the tick enters the body. Grasping the body of the tick may cause the infected bacteria to be squeezed into the skin. With a solid grip, the tick can be pulled firmly, NOT twisted, out of the skin. After removal, putting the tick in a jar of alcohol will kill it. The site of the bite should always be cleaned thoroughly and monitored for up to 30 days. ALDF also recommends against using matches, alcohol or petroleum jelly to get the tick to pull out of the bite as these methods may actually cause more problems.

Recurring Symptoms

Research suggests that LD infection can recur in patients who have not been treated thoroughly or properly. Some patients have also reported recurring symptoms even after an appropriate treatment plan has been followed and recorded. The reason for recurring symptoms and progression to a chronic state is still unknown. The American Lyme Disease Foundation (ALDF) reports that the National Institutes of Health (NIH) plans to fund a research study that will investigate possible reasons why and how LD can progress to a chronic state after appropriate treatment. The study will also examine what is considered appropriate treatment and the specific effectiveness of different treatment options. Hopefully, this type of research will produce new testing procedures to provide more accurate diagnostic results in the near future!

If you have any questions about Lyme disease, your health or your family’s health, visit our Medical Library.

If you would like information about an AmericasDoctor clinical trial, please visit our Clinical Trials FAQ’s. Join a support network of 30 Communities of real people searching for--and offering--support and information about chronic conditions Communities. Reviewed by Steven J. Adashek, MD, FACOG
November 1, 2000 Copyright ©2001 AmericasDoctor

Original Message: Date: 11/30/2001 6:31:18 PM Eastern Standard Tim
In a message dated 11/6/2001 11:27:54 AM Eastern Standard Time, barb writes:
Barb (she was a dear Lyme friend) offered the following as proof of Borrelia persistence.  These emails were originally posted on Actionlyme and also sent privately.

barbfitz. . . .@chartermi.net